Provider Demographics
NPI:1871767707
Name:W. TRENT YADON, DDS
Entity type:Organization
Organization Name:W. TRENT YADON, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:YADON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-256-8668
Mailing Address - Street 1:2211 DOWNS AVE
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-5309
Mailing Address - Country:US
Mailing Address - Phone:580-256-8668
Mailing Address - Fax:
Practice Address - Street 1:2211 DOWNS AVE
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-5309
Practice Address - Country:US
Practice Address - Phone:580-256-8668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4852261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental